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Return to work six months after burn: a prospective study at the Helsinki Burn Center
Raimo Palmu1, Timo Partonen2, Kirsi Suominen3
1Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.
Objective:
Burn and other major injuries often impair survivors' capacity to work. We investigated predictors for not returning to work by six months after acute burn. Differences in demographic, clinical and psychiatric characteristics between burn patients returning to work and those not were examined.
Method:
All consecutive acute burn patients (N=107) admitted to the Helsinki Burn Center were assessed with a structured psychiatric diagnostic interview at baseline. Of the 60 patients working at baseline, 53 patients (88%) participated in the six-month follow-up interview. Variables predicting not returning to work were analyzed in binary logistic regression models.
Results:
Two-thirds (70%, 37 of 53) of the cohort followed returned to work by six months. When compared to patients returning to work, those not returning to work had a higher mean percentage of total body surface area (TBSA) (16.3% vs. 6.2%, p=0.001), and hand burns were more common (75% vs. 41%). The presence of mental disorders during follow-up was also more common (81% vs. 30%, p=0.001), particularly major depressive disorder (MDD) (31% vs. 3%) or delirium (31% vs. 3%). In a multivariate analysis, proportion of total body surface area (%TBSA) burned (B=1.12, p=0.029) and presence of MDD (OR 55.3, p=0.007) or delirium (OR 19.2, p=0.046) significantly predicted not returning to work.
Conclusion:
Majority of the burn patients working at baseline returned to work by six months. Capacity to work after burn is predicted by both smaller %TBSA burned and lack of diagnosable mental disorders, particularly delirium or MDD, after burn.
